Wednesday, November 30, 2016

A Real Trial of Using MDMA to Treat PTSD

MDMA, better known as Ecstasy, was actually used by therapists before it ever become a street drug. But once it spread to the dance clubs and began to kill people the authorities clamped down, and it became a Schedule 1 drug with no legal uses.

Some therapists never lost their interest in the drug, though, hoping to use its mind-opening properties to speed the therapeutic process:

Research has shown that the drug causes the brain to release a flood of hormones and neurotransmitters that evoke feelings of trust, love and well-being, while also muting fear and negative emotional memories that can be overpowering in patients with post-traumatic stress disorder. Patients say the drug gave them heightened clarity and ability to address their problems.

In particular there has been interest in using it to treat Post Traumatic Stress Disorder. The idea is that reviewing the horrible memories under the influence of the drug's flood of good feeling can loosen their hold on the mind and render them less terrifying. Enough anecdotal accounts of people self-medicating themselves with the street version have emerged to make some psychiatrists long for a real trial.

Now, finally, this is getting under way. The Multidisciplinary Association for Psychedelic Studies has completed six small, Phase 2 studies of the drug involving 130 patients, and the results have been good; in one of these studies 2/3 of the patients ended up no longer meeting the diagnostic criteria for PTSD. Some of the patients have raved about their results. "If it weren't for MDMA, I'd be dead," one said. So now there will be a larger, more formal, Phase 3 trial, opening the way for eventual approval of MDMA as a prescription drug.

That might be great for many sufferers, but other people look at our experience with expanding the prescription of opiates for pain and see another drug crisis looming. After all, MDMA is both fun and dangerous, and vulnerable people can get addicted. In the recent studies MDMA is given in a doctor's office, under supervision, so the idea is not to give people a bottle of pills they can take home or sell. Even so, legalizing the drug will increase the supply, and perhaps also convince many people that self-medicating with it might be a good idea.

But then just about everything is dangerous if misused, and I say if it helps any of the wounded, we owe them a chance to try this cure.